rubber dam application parts components and importance

rubber dam presentation

1. Isolation and Rubber Dam
Application

3. Advantages of using a rubber dam
•Accessibility and visibility
•Clean and dry field
•It protects the lips, cheeks and tongue
• Infection control
•Aspiration of instruments and medicaments
•Saliva free while performing endodontic treatment
• It potentially improves the properties of dental materials
• It provides protection to patient and dentist

4. Disadvantages of using a rubber dam
• Damage porcelain crowns/crown margins
• May traumatize gingival tissues
• Careless placing and removal of rubber dam can damage oral mucosa
• There are chances of perforation during preparation of access cavity if tooth is abnormally
positioned
• There are chances of incorrect shade while selecting shade for composite restoration due to bright
colored dam
• blocks off oral airway, it is difficult to use in patient with temporary nasal congestion

5. Contraindications of use of rubber dam
•Asthmatic patients
• Mouth breathers
• Extremely malpositioned tooth
•

6. Rubber dam equipment
• Rubber dam sheet
• Rubber dam clamps
• Rubber dam forceps
• Rubber dam frame
• Rubber dam punch
Rubber dam accessories
•Lubricant
• Dental floss
• Rubber dam napkin
Rbber dam components

8. Rubber Dam Sheet

9. •Rubber dam sheet is normally available in size 5 × 5 or 6×6 sq inches in
light and dark colors.
•Sheet has dry and shiny sides, dull side faces the occlusal surface of
isolated teeth because it is less reflective than shiny surface
•It is available in three thicknesses, light, medium and heavy.
•Thicker dam is effective in retracting the tissues and is more resistant to
tearing. These are preferred for isolating class V cavities with cervical
retainer.
•Thinner dam can easily pass through the contacts easier, so specially
helpful in cases of tight contacts.
•Middle grade is usually preferred as thin is more prone to tearing and
heavier one is more difficult to apply
•Latex-free dam is necessary as the number of patients is increasing with
latex allergy

10. Rubber Dam Clamps
Clamps mainly serve two functions:
1.They anchor the rubber dam to the tooth
2. Help in retracting the gingiva.

11. On the Basis of design
• Winged:These have anterior and lateral wings which provide extra retention of
rubber dam. But these interfere with placement of matrix band retainers and
wedges
• Wingless: They have no wings.
On the Basis of Material Used
• Metallic: Traditionally, clamps have been made from stainless steel. Problem
with
using metallic clamps is that they appear radiopaque on radiograph, thereby
overlapping the structures
• Nonmetallic/plastic: Nonmetallic are made from polycarbonate plastic. These
are radiolucent but they are bulky so don’t easily fit the teeth.
Classification of clamps

14. Rubber Dam Forcep

15. •Rubber dam forcep is used to carry the clamp to the tooth.
• When the handles of forcep are compressed together, it’s two working
ends move apart
• Working end has small projections that fit into two corresponding holes of
the rubber dam clamp
• Area between working end and the handle has a sliding lock device which
locks the handles in positions while the clinician moves the clamp around
the tooth
• It should be taken care that forceps do not have deep grooves at their tips
or they become very difficult to remove once the clamp is in place.

18. Rubber Dam Frame

19. •Rubber dam frame supports the edges of rubber dam
•Modern frames have sharp pins which easily grip the dam.
•Rubber dam frames are available in either metal or plastic
•Plastic frames have advantage of being radiolucent.

20. Rubber dam frames serve following purposes:
• Support the edges of rubber dam
• Retract the soft tissues
• Improve accessibility to the isolated teeth

21. Rubber Dam Punch

22. •Rubber dam punch is used to make the holes in the rubber sheet
through which the teeth can be isolated
•Working end is designed with a plunger on one side and a wheel on
the other side
•This wheel has different sized holes on the flat surface facing the
plunger

23. Rubber Dam Template

24. Rubber Dam Accessories
•Lubricant
Petroleum jelly is often used at corner of mouth to prevent irritation
•Dental Floss
• It is usually required for testing interdental contacts
•Floss is tied to the clamp to prevent its accidental aspiration

25. Methods of Rubber Dam Placement
Method I: Clamp placed before rubber dam

26. Method II: Placement of rubber dam and clamp together
Method III: Split dam technique